Predicting Stroke Outcome Using Clinical- versus Imaging-based Scoring System

Baek, Joon Hyun; Kim, Kitae; Lee, Yeong-Bae; Park, Kee-Hyung; Park, Hyeon-Mi; Sung, Young Hee; Shin, Dong Hoon; Bang, Oh Young

doi:10.1016/j.jstrokecerebrovasdis.2014.10.009

Cited by 16 publications

(15 citation statements)

References 22 publications

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“…Clinical rating or imaging - based scoring systems like ASTRAL, DRAGON or SEDAN have been published to predict loss of functional independence after IS [ 2 – 5 ]. Age, initial stroke severity, onset to admission time, range of visual fields, level of consciousness, glucose and concentrations of serum neutrophil markers were some predictors for losing functional independence in these studies [ 6 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Low self-reported sports activity before stroke predicts poor one-year-functional outcome after first-ever ischemic stroke in a population-based stroke register

et al. 2018

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BackgroundPhysical activity (PA) is associated with lower risk of stroke. We tested the hypothesis that lack of pre-stroke PA is an independent predictor of poor outcome after first-ever ischemic stroke.MethodsWe assessed recent self-reported PA and other potential predictors for loss of functional independence - modified Rankin Scale (mRS) > 2 - one year after first-ever ischemic stroke in 1370 patients registered between 2006 and 2010 in the Ludwigshafen Stroke Study, a population-based stroke registry.ResultsAfter 1 year, 717 (52.3%) of patients lost their independence including 251 patients (18.3%) who had died. In multivariate logistic regression analysis lack of regular PA prior to stroke (Odds Ratio (OR) 1.7, Confidence Interval (CI) 1.1–2.5), independently predicted poor outcome together with higher age (65–74: OR 1.7; CI 1.1–2.8, 75–84 years: OR 3.3; CI 2.1–5.3; ≥85 years OR 14.5; CI 7.4–28.5), female sex (OR 1.5; CI 1.1–2.1), diabetes mellitus (OR 1.8; CI 1.3–2.5), stroke severity (OR 1.2; CI 1.1–1.2), probable atherothrombotic stroke etiology (OR 1.8; CI 1.1–2.8) and high leukocyte count (> 9.000/mm3; OR 1.4; CI 1.0–1.9) at admission. Subclassifying unknown stroke etiology, embolic stroke of unknown source (ESUS; n = 40, OR 2.2; CI 0.9–5.5) tended to be associated with loss of independence.ConclusionIn addition to previously reported factors, lack of PA prior to stroke as potential indicator of worse physical condition, high leukocyte count at admission as indicator of the inflammatory response and probable atherothrombotic stroke etiology might be independent predictors for non-functional independence in first-ever ischemic stroke.

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Section: Introductionmentioning

confidence: 99%

Low self-reported sports activity before stroke predicts poor one-year-functional outcome after first-ever ischemic stroke in a population-based stroke register

et al. 2018

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“…14 The score can also be used as a patient comparative tool between studies or as a surrogate imaging marker in prognostic studies. 15 The higher the ASPECTS, the better the prognosis. 1 Considered in this fashion, the reliability of ASPECTS has been measured with ICCs, a method that will take into account any degree of proximity between 2 scores attributed to the same patient.…”

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confidence: 99%

Early CT changes in patients admitted for thrombectomy

et al. 2016

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“…[24913] The results of our study show that patients with a DRAGON score of 7–8 had significantly worse clinical outcomes (mRS ≥4) and higher mortality compared to patients with DRAGON scores ≤6. This demonstrates that the DRAGON score can predict patient clinical outcomes after treatment with IV tPA and endovascular therapy.…”

Section: Discussionmentioning

confidence: 85%

“…[24913] Our study results show that the DRAGON score can in fact be applied to endovascular patients who have already received IV tPA.…”

Section: Discussionmentioning

confidence: 92%

DRAGON score predicts functional outcomes in acute ischemic stroke patients receiving both intravenous tissue plasminogen activator and endovascular therapy

et al. 2017

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Background:The DRAGON score, which includes clinical and computed tomographic (CT) scan parameters, predicts functional outcomes in ischemic stroke patients treated with intravenous tissue plasminogen activator (IV tPA). We assessed the utility of the DRAGON score in predicting functional outcome in stroke patients receiving both IV tPA and endovascular therapy.Methods:A retrospective chart review of patients treated at our institution from February 2009 to October 2015 was conducted. All patients with computed tomography angiography (CTA) proven large vessel occlusions (LVO) who underwent intravenous thrombolysis and endovascular therapy were included. Baseline DRAGON scores and modified Rankin Score (mRS) at the time of hospital discharge was calculated. Good outcome was defined as mRS ≤3.Results:Fifty-eight patients with LVO of the anterior circulation were studied. The mean DRAGON score of patients on admission was 5.3 (range, 3–8). All patients received IV tPA and endovascular therapy. Multivariate analysis demonstrated that DRAGON scores ≥7 was associated with higher mRS (P < 0.006) and higher mortality (P < 0.0001) compared with DRAGON scores ≤6. Patients with DRAGON scores of 7 and 8 on admission had a mortality rate of 3.8% and 40%, respectively.Conclusions:The DRAGON score can help predict better functional outcomes in ischemic stroke patients receiving both IV tPA and endovascular therapy. This data supports the use of the DRAGON score in selecting patients who could potentially benefit from more invasive therapies such as endovascular treatment. Larger prospective studies are warranted to further validate these results.

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Predicting Stroke Outcome Using Clinical- versus Imaging-based Scoring System

Cited by 16 publications

References 22 publications

Low self-reported sports activity before stroke predicts poor one-year-functional outcome after first-ever ischemic stroke in a population-based stroke register

Low self-reported sports activity before stroke predicts poor one-year-functional outcome after first-ever ischemic stroke in a population-based stroke register

Early CT changes in patients admitted for thrombectomy

DRAGON score predicts functional outcomes in acute ischemic stroke patients receiving both intravenous tissue plasminogen activator and endovascular therapy

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